Your Pills Are Spying on You

There’s a new psychiatric medication on the market called Abilify MyCite. On its own, the drug Abilify is a partial dopamine agonist that has been approved by the Food and Drug Administration since 2013 as an anti-psychotic medication. It’s generally prescribed to people with conditions such as such as schizophrenia and bipolar disorder, though questions remain about its effectiveness and the severity of its side effects. The “MyCite” pill, approved just last year, does something new. It contains a digital sensor that tracks whether a patient has ingested the drug, then shares that information with doctors, family, or whoever is programmed to receive it.

The use of Web technology to track medication has been emerging over the past decade or so. The technology has arrived with the usual benefits and risks of the Internet of Things: timely reminders, cool gadgets, vulnerability to hacking, loss of control over one’s data, state surveillance. When it comes to a pill like MyCite, America’s history of coercive psychiatric medication intensifies the risks. If the medical technology is simply used to help people remember to voluntarily take their pills, so much the better. Alas, that’s unlikely to be the case.

People with psychiatric disabilities, especially poor and otherwise vulnerable people, are too often forced to choose between mandatory compliance and basic freedom. MyCite makes it easier to demand that people surrender their privacy in order to conform to some artificial idea of normal.

There’s nothing wrong with creating new digital tools to help people keep track of their medication. Lots of folks are disorganized and forgetful and eager for the reminders. I take a daily antacid and often stare at the bottle, trying to remember whether I took it before I had coffee. Non-adherence, as the medical profession refers to it when people don’t take the drugs they’ve been prescribed, is widespread, and its consequences are expensive. Experts estimate that people don’t complete medication cycles at least 25 percent of the time, with some estimates rising to 50 percent. When people don’t take their medication, their medical needs re-occur or intensify, resulting in an estimated $100 billion per year in otherwise preventable medical costs.

Abilify is the first FDA-approved pill with a tracking mechanism, but it’s hardly the first medical entry in the Internet of Things. Medical devices such as insulin pumps, pacemakers, and CPAP breathing devices can all be enabled to report data back to users and medical professionals alike.

Given the high-stakes nature of the first two, where insulin use and regulating heartbeats can literally be life-saving, these technological changes make sense on the surface. There have been some problems, though. First, all Internet-enabled tech can be hacked. Last fall, the FDA recalled 500,000 Internet-connected pacemakers over security concerns. Medical device giant Johnson & Johnson warned consumers that its insulin pumps could be hacked. The idea of someone turning off your heart by hacking is the scary stuff of science fiction, and might well be a real threat.